Rebecca, you'll get some helpful tips from members like @sepdvm @ltecato @ascc17 @larson1540. @kecm was asking very similar questions and has since had surgery and can also help.

- Anyone had neck dissection surgery? What are your tips? https://connect.mayoclinic.org/discussion/neck-malignant-lymph-node-cancer-recurrence/

Many of these members also have experience with radiation too.

I had the surgery after the radiation. It might be better to have the surgery first because radiation reduces the oxygen supply to the tissue.

My surgery caused a permanent loss of sensation in that region of my neck and a lot of persistent and “loud” tingling from the damaged nerves. My sternocleidomastoid muscle was removed on one side. Muscle spasms were bad for a couple of years and still flare up. You have to have physical therapy to get your neck and shoulders straightened out. Therapists will be criticizing your posture a lot. The shoulder on the surgery side will look like it belongs to a bodybuilder because it has to work harder.

As far as radiation, you might lose saliva permanently. No one appreciates saliva until it’s gone. Then you can say “Goodbye teeth” unless you do exactly what the radiologist and dentist tell you to do about oral hygiene and fluoride treatments. I didn’t because I was a young fool. I regret that every day now.

Radiation causes two other side effects: trismus and dysphagia, but in my case they didn’t effect me much until about 30 years after the cobalt treatments. Trismus is another word for lockjaw. It makes dental problems a lot harder to address, so like I said, you should heed the warnings about getting a Water Pic and using it.

Dysphagia is trouble swallowing. I am now on a “soft mechanical/full-liquid” diet. I have not been able to eat “regular” food for at least 5 years. But I was fairly normal for 20 years after radiation. The tissue damage apparently gets worse with age.

If the dysphagia is bad enough, the patient can get a feeding tube but the tubes are controversial. They are supposed to prevent aspiration pneumonia but the evidence of efficacy is less than convincing. I had one for a while and hated it. For one thing, the tube falls out or wears out every six months or so. I am biased against feeding tubes, obviously, but some people do not have a choice, I guess.

My initial surgery involved a select neck dissection, but while part of the parotid salivary gland was removed for involvement in tumor, the regional lymph nodes were all clear at that time. With positive lymph nodes the surgery might be more extensive than mine was. Radiation followed a month later with a targeted therapy infusion weekly to sensitize the tumor to radiation. I had no real issues with that part of the surgery other than a partially dry mouth which has worsened with time ( 10 years have passed). Radiation caused skin rash and mouth ulceration and big changes to my taste sense. I did not have a feeding tube because I was always able to swallow soft foods and liquids. Have any dental issues addressed prior to radiation with a knowledgable dentist. Mine was not. There was a mixture of Maalox and benadryl and an antifungal called Magic Mouthwash from the oncologist at Univ. of MI which was dispensed and helped with mouth pain. There is also a topical oral lidocaine gel to use for mouth pain. You can lose a lot of weight during the 7 weeks of radiation, but healing starts right away once it is stopped. It takes a months for taste to return to a new normal. There are many remedies available for dry mouth and I continue to find more solutions. Staying hydrated is so important during and after so drinking electrolyte solutions and water helps. I did need IV fluids toward the end of radiation as it was hot summer and I was also nauseated from the chemotherapy. Best of luck to you. I'm glad you can enjoy the holiday before all of this treatment begins.